non-Western Migrants Research Articles

Intersectionele sekse- en herkomstverschillen in nietwerken: Een verklaring op basis van sociaal kapitaal

Intersectional sex and country of origin differences in non-employment: an explanation based on social capital. In this article we study to what extent intersectional sex- and country of origin differences in non-employment in the Netherlands are mediated by social capital. Hypotheses are formulated based on literature concerning intersectionality, social resources, traditional gender roles and homogeneous social preferences. We expect that certain groups are more vulnerable to non-employment than other groups, in part because fewer of their strong social ties are currently active in the labour market. We estimated structural equation models using data from the LISS-panel. We find that having fewer ties that have paid employment is linked to a higher chance of being non-employed. Moreover, we find that people from certain social groups have a higher chance of being unemployed. For women with a non-western migration background we find that a part of the higher risk for non-employment can be attributed to a lack of social capital.

Residential green space associated with the use of attention deficit hyperactivity disorder medication among Dutch children.

Several studies have observed an inverse relationship between attention deficit hyperactivity disorder (ADHD)-related behavior of children, as reported by parents or teachers, and the amount of green space in their residential environment. Research using other, more objective measures to determine ADHD prevalence is scarce and could strengthen the evidence base considerably. In this study, it is investigated whether a similar beneficial association will be observed if the use of ADHD-related medication is selected as an outcome measure. More specifically, registry data from a health insurance company on the reimbursement of ADHD-related medication in 2011 were available for 248,270 children between 5 and 12 years of age. Amounts of green space within 250 and 500 m of the home address were calculated. Multilevel logistic regression analyses for the prevalence of use were conducted, including the following covariates: sex, age, urbanity of the neighborhood, neighborhood socioeconomic status (SES), and percentage of people with a non-Western migration background in the neighborhood population. Results showed that the amount of green space was inversely related to the prevalence of use of ADHD medication. Moreover, the relationship was strongest among children living in the least wealthy neighborhoods and absent among those living in the wealthiest neighborhoods. Results also show that in less wealthy neighborhoods, there is, on average, less green space available nearby: children who are likely to benefit most from nearby green space tend to have the least of it.

Religion and COVID-19 Vaccination Coverage in the Netherlands between August 2021 and February 2022

This article explores the possible relationship between religion and the COVID-19 vaccination coverage in the Netherlands by addressing the following research questions: (1) to what extent is religious affiliation a factor in the COVID-19 vaccination coverage in the Netherlands? and (2) to what extent has this possible effect of religious affiliation changed over time? Our analyses reveal a strong and persistent effect of the proportion of orthodox Protestants per municipality on the vaccination coverage per municipality and no such effect for the proportion of Catholics. Furthermore, the analysis also reveals a similar effect for the proportion of Muslims, but this effect disappears when controlled for the proportion of non-Western migrants.

Spatial variation in tobacco smoking among pregnant women in South Limburg, the Netherlands, 2016–2018: Small area estimations using a Bayesian approach

The aim of this study was to provide small area estimations (SAE) of smoking prevalence during pregnancy in South Limburg, the Netherlands. To illustrate improvements in accuracy and precision of estimates compared to traditional frequentist analyses, we used Bayesian inference with the Integrated nested Laplace approximation to account for spatial structures and area-level proxies. Results revealed a heterogenous prevalence of smoking with a range between 6.7% (95% credible interval 4.7,8.7) and 16.7% (14.3,19.2) among municipalities; and an even more heterogenous prevalence among neighbourhoods a range from 0 (-14.9,6.5) to 32.1 (20.3,46.8). Clusters with significant lower- and higher-than-average risk were identified (RR between 0.6-1.4 and 0.0-2.4 for municipality- and neighbourhood-level, respectively). Higher proportion of non-western migrants and lower average income were associated with higher prevalence of tobacco smoking. The obtained estimates should inform local prevention policies, as well as provide methodological example for public health researchers on application of Bayesian methods for SAE.

Palliative Care Utilisation Among Non-Western Migrants in Denmark: A Qualitative Study Of the Experiences of Patients, Family Caregivers and Healthcare Professionals.

This study explores care experiences while utilising palliative care services of non-western migrant families from the perspectives of patients, family caregivers, and healthcare professionals in Denmark. Twenty-three semi-structured individual and group interviews were conducted among eight patients with a life-threatening disease, 11 family caregivers, and ten healthcare professionals. Thematic analysis revealed three themes: 1) Communication between families and healthcare professionals; 2) Building and lack of trusting relations, and feeling safe, and 3) Access to information and navigating in the healthcare system. Moreover, ''language and culture'' emerged as transaction themes that are not mutually exclusive, however, interconnect across the mentioned three themes. Non-western migrant families can be supported by healthcare professionals' cultural competency training, negotiating on providing services concerning information, patient preferences, family involvement, and palliative care setting. This study findings urge inter-sectoral collaboration to ensure needs-oriented and linguistically and culturally appropriate palliative care services for non-western migrant families in Denmark.

Welcoming the unwelcome: Migration industries and border control for homeless job-seeking migrants in central Copenhagen

As modes of border control increasingly shift to cities, private charities that engage in caring for non-national homeless migrants risk, unintentionally and unwillingly, serving the so-called ‘migration industries’ as front agencies for the European border regime. Since the 2008 financial crisis, which hit migrant populations in southern Europe particularly hard, the number of homeless migrants sleeping rough in northern European cities has increased. In Copenhagen, these new homeless include jobless West African men who reside in Spain or Italy but are transiently in the city to reboot their lives by collecting empty deposit-carrying bottles left on the streets. Political will to address this rising social problem at state and city levels has so far been limited, leaving the private non-profit charities of central Copenhagen as sole providers of care for homeless migrants. This article examines how these long-established institutions, which used to provide care primarily to locals with substance dependencies or mental health problems, have transformed into migrant industries shaped by the logic of the European border regime. For this purpose, prior research on urban borderlands and homeless migrants is reviewed, and documents issued by non-profit charities operating in the field of urban homelessness are analysed. The article focuses on the increasingly hostile elements of state and municipal policies on non-Western migrants, which work to divide ‘our’ homeless from the migrant ‘others’. It also considers the various ways in which charities work to enable different survival strategies to emerge and be maintained among migrants without access to the formal labour market, and finally how charities’ transformed role affects their relationships with local residents.

Erratum to: What works in an integrated approach obesity for people with a low socio-economic position and/or a non-Western migration background?

Erratum to: What works in an integrated approach obesity for people with a low socio-economic position and/or a non-Western migration background?

The Making of the Licitness of Right-Wing Rhetoric: A Case Study of Digital Media in the Netherlands

In the Netherlands, the challenges of the multicultural society are high on the political agenda. At present 24.4% of the Dutch population has an immigration background of which 13.9% has a non-western migration background and almost 50% of all the people with a migration background are second-generation migrants born in the Netherlands. However, today’s Dutch multicultural society is associated with a complex range of challenges linked with cultural and religious diversity. This article investigates how news media in the Netherlands facilitated the making of the licitness of xenophobic rhetoric of the two main Dutch populist right-wing parties Partij voor de Vrijheid (PVV) and Forum voor Democratie (FvD) during the Provincial Elections in March 2019. I conclude that these rising political extremist movements dominate the immigration debate and are accountable for the making of the licit social resentment against particularly non-western immigrants.

Occurrence and Timing of Advance Care Planning in Persons With Dementia in General Practice: Analysis of Linked Electronic Health Records and Administrative Data.

BackgroundAdvance care planning (ACP) is a process of communication in which patients and family caregivers discuss preferences for future care with the healthcare team. For persons with dementia, it is crucial to timely engage in ACP. Therefore, we study ACP in dementia using electronic health record data. This study aims to determine how often ACP conversations are recorded, analyze time from dementia diagnosis until the first recorded conversation and time from the first recorded conversation to death, and analyze which factors are associated with the timing of ACP.MethodsElectronic records of 15,493 persons with dementia in Dutch general practice between 2008 and 2016 were linked to national administrative databases. ACP conversations and indicators of health deficits to determine frailty were obtained from electronic records coded with the International Classification of Primary Care. Socio-demographic characteristics were derived from the national population registry managed by Statistics Netherlands. Date of death was derived from the Personal Records Database (2008–2018).ResultsACP was recorded as such as 22 (95% CI, 20–23) first conversations per 1,000 person-years of follow-up. The hazard ratio (HR) for the first conversation increased every year after dementia diagnosis, from 0.01 in the first year to 0.07 in the 7th and 8th year after diagnosis. Median time from a first conversation to death was 2.57 years (95% CI, 2.31–2.82). Migrant status [non-Western vs. Western (HR 0.31, 95% CI, 0.15–0.65)] was significantly associated with a longer time from dementia diagnosis to the first conversation. Being pre-frail (HR 2.06, 95% CI, 1.58–2.69) or frail (HR 1.40, 95% CI, 1.13–1.73) vs. non-frail was significantly associated with a shorter time from dementia diagnosis to the first ACP conversation.ConclusionACP conversations in Dutch general practice were rare for persons with dementia, or was rarely recorded as such. In particular among persons with a non-Western migration background and those who are non-frail, it started long after diagnosis. We advise further research into public health and practical strategies to engage persons with dementia with a non-Western migration background and non-frail persons early in the disease trajectory in ACP.

Polypharmacy occurrence and the related risk of premature death among older adults in Denmark: A nationwide register-based cohort study.

Polypharmacy, defined as the concurrent use of ≥5 medications, increases the risk of drug-drug and drug-disease interactions as well as non-adherence to drug therapy. This may have negative health consequences particularly among older adults due to age-related pharmacokinetic and pharmacodynamic changes. This study aims to uncover the occurrence of polypharmacy among older adults in Denmark and investigate how polypharmacy relates to mortality. This nationwide register-based study included 1,338,058 adults aged 65+ years between January 2013 and December 2017 in Denmark. Polypharmacy prevalence was measured at time of inclusion while incidence and the association between polypharmacy and mortality were measured over the five-year follow-up using Cox regression. In an attempt to adjust for confounding by indication, propensity scores with overlap weighting were introduced to the regression model. At time of inclusion, polypharmacy prevalence was 29% and over the five years follow-up, 47% of the remaining adults transitioned into polypharmacy. Identified risk factors included multimorbidity (2+ morbidities: HR = 3.51; 95% CI = 3.48-3.53), age (95+ years: HR = 2.85; 95% CI = 2.74-2.96), socioeconomic factors (Highest income quartile: HR = 0.81; 95% CI = 0.80-0.81), region of birth region (Non-western migrants: HR = 0.77; 95% CI = 0.75-0.79), marital status (Divorced: HR = 1.10; 95% CI = 1.10-1.12) and year of inclusion (2017: HR = 1.19; 95% CI = 1.19-1.22). Further analyses showed that polypharmacy involves many different drug cocktails with medication for the cardiovascular system (95%), blood and blood-forming organs (69%), alimentary tract and metabolism (61%) and nervous system (54%) contributing the most. After adjustment for propensity scores with OW, both polypharmacy (HR = 3.48, CI95% = 3.41-3.54) and excessive polypharmacy (HR = 3.48, CI95% = 3.43-3.53) increased the risk of death substantially. A considerable proportion of older adults in Denmark were exposed to polypharmacy dependent on health status, socio-economic status, and societal factors. The associated three- to four-fold mortality risk indicate a need for further exploration of the appropriateness of polypharmacy among older adults.

Exclusionary Contexts Frustrate Cultural Integration: Migrant Acculturation Into Support for Gender Equality in the Labor Market in Western Europe

Countering linear acculturation theories, the adoption of Western European gender customs over time differs across migrant groups. This diversity implies that acculturation into support for gender equality is context dependent. However, little quantitative scholarship has identified what sort of contexts strengthen or impede acculturation. This article investigates one source of context-dependent acculturation: exclusionary contexts. I build and test a context-dependent exclusions framework that proposes that contexts that exclude non-Western migrants hamper their acculturation into support for gender equality in the labor market in Western Europe. Empirically, I synchronize European Social Survey, European Values Study, and Eurislam data on over 11,000 non-Western migrants in Western Europe. Cross-classified models show that non-Western migrants’ support for labor-market gender equality is, indeed, lower in exclusionary contexts, for instance, in destinations with stronger anti-migrant sentiments. Pivotally, the impact of destinations’ gender customs on migrants’ gender values differs across destination, origin, and community contexts. For instance, in destinations with stronger populist right-wing parties, migrants internalize destinations’ gender equality less. Altogether, non-Western migrants’ acculturation into support for labor-market gender equality is highly dependent on contextual exclusions, which means that populist claims about non-Western migrants’ universal lack of acculturation into support for gender equality should be viewed cautiously.

Risk factors of loneliness across the life span

Although loneliness is typically associated with adolescence and old age, research has revealed that it is prevalent across the life span. The present study contributes to the loneliness literature by investigating a broad range of risk factors in a Dutch sample ( N = 52,341) ranging from late adolescence to old age using a cross-sectional survey administered by the regional public health services in the province of Limburg in the Netherlands. Risk factors associated with higher levels of self-reported loneliness across the life span were being male, lower education levels, inadequacy of financial resources, mental health, informal caregiving that is experienced as burdensome, and limited social contact or network type. In addition, in early adulthood, having a non-western migration background and having a physical disability were associated with higher levels of loneliness, whereas living alone, having a non-western migration background, and not having a paid job were risk factors of loneliness in middle adulthood. In late adulthood, living alone and having a physical disability were associated with loneliness. The present study demonstrates that different stages of life are associated with different vulnerability factors of loneliness. Hence, the prevention of loneliness might require different interventions in different age groups.

COVID-19 Lockdown-Related Changes in Mood, Health and Academic Functioning.

The COVID-19 pandemic lockdowns were accompanied by an abrupt transition from face-to-face education to online education. The aim of this study was to evaluate the impact of the COVID-19 pandemic on academic functioning and mood in Dutch pharmacy students and PhD candidates. A total of n = 341 participants completed an online survey including questions on mood and academic functioning, assessed retrospectively for before and during the COVID-19 pandemic. Overall, during COVID-19 lockdown, significantly more time was spent on academic activities, and study grades/output significantly improved. However, the overall effects were of small magnitude, and there was great variability among students, reporting either improved, unchanged or poorer academic functioning. Compared to before COVID-19, the lockdown periods were associated with significantly increased levels of stress, anxiety, depression, fatigue, and loneliness, and a significant reduction in optimism and happiness. Significant negative correlations were found between ‘performance quality’ and stress, ‘performance quality’ and fatigue, ‘study grades/output’ and stress, and between ‘study grades/output’ and fatigue. Correlations of mood and items related to academic interactions were not statistically significant. Differential effects were seen when the data was analyzed according to sex, living situation, and ethnicity, revealing that women, students living alone, and those with a migration background reported that COVID-19 lockdowns had greater negative mood effects and a more negative impact on academic functioning. Poorer sleep quality and reduced quality of life were significantly associated with reduced mood, as well as reduced academic performance quality and role satisfaction. Regression analysis revealed that being young and not having a non-Western migration background were predictors of improved performance quality. However, only being young was a significant predictor of improved study grades/output during the COVID-19 pandemic. Increased levels of stress and fatigue were significant predictors of both reduced performance quality and poorer study grades/output during the COVID-19 pandemic. In conclusion, for the sample as a whole, the transition to online education during the COVID-19 lockdown was judged as having significant positive effects on academic performance. The lockdown periods were associated with significantly reduced mood and reduced social interactions. It should be taken into account that about one third of students reported academic functioning to be poorer during the COVID-19 pandemic. This represents a substantial group of students who require more attention and guidance to make a successful transition to online education and cope with lockdown-associated stress and fatigue.

Normalising power and engaged narrative methodology: refugee women, the forgotten category in the public discourse

Since the beginning of the 21st century, the discourse of othering of non-Western migrants has been growing in many European societies. And since 2015, refugees have become a quite visible component in this discourse. Although, for decades, the dominant image of refugees has been constructed as people ‘at risk’, new competing images of refugee men ‘as risk’ have recently gained ground. For refugee women, however, the image of being victims and ‘at risk’ still prevails. This shows a strong underlying gendered logic of feminine vulnerability and masculine threat. In this article, I show how these images are situated within the dominant Dutch discourse of migration with taken-for-granted taxonomies of the self and the other. Specific in this normalised discourse for refugee women is that their agency is either ignored or their possible position as activists is not acknowledged to exist. Using examples from two studies in which my research team engaged with the method of narrative engaged research, I show the importance of this particular narrative method in unsettling the normalising power of othering. The theoretical argument of this article engages with ongoing discussions on power and agency. It argues that, when the power of exclusion works through repetition and is manifested in the daily normalisation of actions, agency needs to provide an alternative in the same fluid manner. Narratives in dialogue provide an illuminating angle for discussing this specific kind of agency, as I will show through some examples from research.

Palliative Care Utilization Among Non-Western Migrants in Europe: A Systematic Review.

The paper aims to identify and describe the European evidence on opportunities and barriers to access and utilization of palliative care among non- western migrants. A systematic review in accordance with PRISMA guidelines was conducted in June 2020, searching Medline, CINAHL, PsychINFO and EMBASE databases. PROSPERO# CRD42020193651. Studies included empirical research published between 2011 and 2020. Search words were, for example, ethnic groups and palliative care. Thematic analysis was used to analyze data. Twenty nine qualitative and six quantitative studies were included. Four main themes were identified: communication and language; knowledge and awareness; patient preferences, cultural and religious issues; and lack of resources at different levels of palliative care service provision. Migrants' access to palliative care is impeded at system, community and individual levels, yet, recommendations are mostly at the individual level. Closer attention is required to these different levels when designing future palliative interventions for migrants.

Dealing with disability: challenges in Dutch health care of parents with a non-Western migration background and a child with a developmental disability

Purpose Parents of children with developmental disabilities who have a non-western migration background often experience unique challenges in foreign health care systems. This study aimed to describe these experiences to better understand these challenges and thereby improve health care provision. Method Twelve parents were interviewed using in-depth, semi-structured interviews. Our data was analysed, and themes were identified using open, selective, and axial coding. Results Multiple parents in our study had a different perception of what constitutes a “handicap”, may regard it as something that is very severe and highly stigmatized and will be less aware of the complex system of care professionals that aim to support them in the care for their child. Additionally, communication with care professionals may be complicated because of language differences and expectations about the division of roles and responsibilities between parents and professionals. This may result in lower involvement in health care. Conclusion As a result of cultural differences in the meaning, information and interaction about disabilities, non-western migrant parents will have a harder time coping with the diagnosis of their child’s disability and will experience more challenges with their involvement in health care. 1 Implications for Rehabilitation To be aware that non-western parents who are told their child has a disability are likely to experience more shame, fear of stigma and may have other definitions of disability than western parents. To pay specific attention to explain as much as possible about the causes, meaning and medical as well as societal future expectations for children with a disability to parents with another cultural background. To explore which knowledge parents have about their child's disability and the Dutch health care system, so that information and support can be personalized. To make sure there are translators present who can not only translate in the correct language but who can also explain commonly used terms for disabilities and other medical concepts, diagnostic procedures, and other specificities of the health care system of the host country to migrant parents. To psycho-educate parents with a migrant background that they are expected to be actively involved in the professional care for their child with a disability without this having negative consequences for the care of their child.

Civil Servants and Non-Western Migrants' Perceptions on Pathways to Health Care in Serbia-A Grounded Theory, Multi-Perspective Study.

(1) Background: Informal patient payments continue to persist in the Serbian health care system, exposing vulnerable groups to private spending on health care. Migrants may in particular be subject to such payments, as they often experience barriers in access to health care. Little is known about migrants paying informally to access health care in Serbia. The study aims to explore pathways of accessing health care, including the role of informal patient payments, from the perspectives of civil servants and non-western migrants in Serbia. (2) Methods: Respondents (n = 8 civil servants and n = 6 migrants) were recruited in Belgrade in 2018, where semi-structured interviews were conducted. The interviews were analysed applying the grounded theory methodological steps. (3) Results: Data reveal different pathways to navigate the Serbian health care system, and ultimately whether paying informally occurs. Migrants appear less prone to paying informally and receive the same or better-quality health care. Locals experience the need to pay informal patient payments, quasi-formal payments and to bring medicine, materials or equipment when in health facilities. (4) Conclusions: Paying informally or using private care in Serbia appear to have become common. Despite a comprehensive health insurance coverage, high levels of out-of-pocket payments show barriers in accessing health care. It is highly important to not confuse the cultural beliefs with forced spending on health care and such private spending should be reduced to not push people into poverty.

Hospitalisation rates differed by city district and ethnicity during the first wave of COVID-19 in Amsterdam, The Netherlands

BackgroundIt is important to gain insight into the burden of COVID-19 at city district level to develop targeted prevention strategies. We examined COVID-19 related hospitalisations by city district and migration background in the municipality of Amsterdam, the Netherlands.MethodsWe used surveillance data on all PCR-confirmed SARS-CoV-2 hospitalisations in Amsterdam until 31 May 2020, matched to municipal registration data on migration background. We calculated directly standardised (age, sex) rates (DSR) of hospitalisations, as a proxy of COVID-19 burden, per 100,000 population by city district and migration background. We calculated standardised rate differences (RD) and rate ratios (RR) to compare hospitalisations between city districts of varying socio-economic and health status and between migration backgrounds. We evaluated the effects of city district and migration background on hospitalisation after adjusting for age and sex using Poisson regression.ResultsBetween 29 February and 31 May 2020, 2326 cases (median age 57 years [IQR = 37–74]) were notified in Amsterdam, of which 596 (25.6%) hospitalisations and 287 (12.3%) deaths. 526/596 (88.2%) hospitalisations could be matched to the registration database. DSR were higher in individuals living in peripheral (South-East/New-West/North) city districts with lower economic and health status, compared to central districts (Centre/West/South/East) (RD = 36.87,95%CI = 25.79–47.96;RR = 1.82,95%CI = 1.65–1.99), and among individuals with a non-Western migration background compared to ethnic-Dutch individuals (RD = 57.05,95%CI = 43.34–70.75; RR = 2.36,95%CI = 2.17–2.54). City district and migration background were independently associated with hospitalisation.ConclusionCity districts with lower economic and health status and those with a non-Western migration background had the highest burden of COVID-19 during the first wave of COVID-19 in Amsterdam.

Use of acute care services by adults with a migrant background: a secondary analysis of a EurOOHnet survey

BackgroundHigh demands create pressure on acute care services, such as emergency medical services (EMS), emergency departments (ED) and out-of-hours primary care (OOH-PC) services. A variety of patient- and organisational factors have been discussed as reasons why especially non-western migrants more frequently contact an ED or OOH-PC service than native born. We aim to investigate whether persons with a non-western and western migrant background more often contact an acute care service than native born and how this relates to the number of contacts with their general practitioners (GPs). In addition, we aim to explore how possible differences in acute care use by migrants can be explained.MethodsWe performed secondary analysis of data collected for the EurOOHnet survey on OOH help-seeking behaviour in Denmark, the Netherlands and Switzerland. Differences in self-reported acute care use (sum of number of contacts with OOH-PC, the ED and 1–1-2/1–4-4) between non-western and western migrants and native born were tested with a quasi Poisson regression analysis. Mediation analyses were performed to examine the impact of factors related to help-seeking on the relation between self-reported acute care use and migrant background.ResultsNon-western migrants had more acute care contacts than native born (adjusted IRR 1.74, 95% CI 1.33–2.25), whereas no differences were found between western migrants and native born. Migrants who regularly contacted OOH-PC or the ED also regularly contacted their GP. Mediation analyses showed that the factors employment, anxiety, attitude towards use of OOH-PC and problems in accessing the own GP could partly explain the higher acute care use of non-western migrants.ConclusionThe higher use of acute care services by non-western migrants compared with native born could partly be explained by feeling fewer barriers to contact these services, feeling more anxiety, more unemployment and problems making an appointment with the GP. Increasing awareness and improving GP access could help migrants in navigating the healthcare system.

Tokenizing and Articulating Protection of Women in Migration Law: Strategies of Exclusion in Contemporary Europe and the Nineteenth-Century USA

This article investigates continuities in migration law-making that claims to aim at protecting women but in effect is a tokenist strategy excluding non-Western female migrants. It shows that despite developments in the legal recognition of women’s equality, present restrictions on family reunification in Western Europe, illustrated through the EU and Danish migration laws, echo law-making in the late 19th-century US, exemplified in the process of adopting the Page Act, which also introduced stricter rules for female migrants under the stated objective of protecting women. Using the social theory of articulation, the article demonstrates how legislators continuously articulate and rearticulate the wellbeing of migrant women to legitimize discriminatory migration rules regardless of how highly women’s rights are respected in law and society. The article contributes to previous feminist scholarship in migration law by showing the continuity and intentionality of the articulative practices in law-making directed at migrant women.